Subfrontal-basal interhemispheric approach for anterior communicating artery aneurysms. Technical note

Area of Science:

• Neurosurgery
• Vascular Neurosurgery
• Surgical Neurology

Background:

• Anterior communicating artery aneurysms present significant surgical challenges.
• Standard pterional-subfrontal approaches may require extensive dissection and brain retraction.

Purpose of the Study:

• To describe a modified pterional-subfrontal approach for anterior communicating artery aneurysms.
• To achieve adequate aneurysm exposure while minimizing brain retraction.

Main Methods:

• Modification of the standard pterional-subfrontal approach.
• Dissection of the basal interhemispheric fissure caudally.
• Focus on exposing aneurysms without rectal gyrus resection.

Main Results:

• The modified approach provides full exposure of the aneurysm.
• High-positioned and posteriorly projecting aneurysms were successfully exposed.
• Preservation of the rectal gyrus was achieved.

Conclusions:

• The modified pterional-subfrontal approach is effective for anterior communicating artery aneurysms.
• This technique potentially reduces surgical morbidity by avoiding rectal gyrus removal.